Papua and New Guinea medical journal
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Plasmodium vivax is a major cause of malarial infection and disease in young children in Papua New Guinea. Recent increase in funding for malaria control has improved accessibility to preventive measures, diagnosis and artemisinin combination therapies. Yet the current treatment and control measures are more effective against P. falciparum than against P. vivax and P. ovale due to the biological differences in the liver stage life-cycle of these parasites. ⋯ Furthermore, there is a paucity of primaquine safety and tolerability data, especially in young children with the highest P. vivax disease burden. For malaria control and elimination efforts to be effective, interventions such as mass drug administration must include primaquine. This opinion paper highlights the need to eradicate hypnozoites in the liver of the human host with primaquine treatment for radical cure of malarial illness and discusses the challenges in the use of primaquine as a public health tool for malaria control and elimination programs in countries such as Papua New Guinea.
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In December 2010 there was a diarrhoea outbreak in Ambunti District, East Sepik Province that was presumed to be cholera. This short report describes the outbreak and outlines the preventive strategies that were implemented to contain the outbreak. Lessons learnt are also discussed.
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Cholera is a severe diarrhoeal illness caused by infection with the bacterium Vibrio cholerae. From July 2009 to late 2011 Papua New Guinea (PNG) experienced thefirst outbreak of cholera ever reported in this country. ⋯ The origin of this outbreak is unknown, but considering the remote location of the initial outbreak an infected international traveller is unlikely to be the source. In this paper we review the characteristics of the PNG cholera outbreak and discuss the ongoing threat of cholera to the country and the region.
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We report on the results of a retrospective audit of airway management in patients presenting to the Port Moresby General Hospital from 1998 to 2009. Safe and secure airway management can be challenging in the operating room during head and neck surgery. These challenges continue into the postoperative period and can present significant issues to intensive care staff. ⋯ This series highlights the importance of anticipating the possibility of difficult airway preoperatively and modifying the airway management appropriately. We consider that all members of the operating team including surgeons, anaesthetists, intensive care physicians and nursing staff should cooperate and communicate effectively to optimize outcomes for these potentially difficult cases. A proposed airway management algorithm is presented to guide surgical teams performing head and neck surgery in Papua New Guinea and similar regions.
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This descriptive questionnaire-based study carried out between 16 June and 30 September 2010 aimed to assess the knowledge among doctors at Port Moresby General Hospital of basic life support and cardiopulmonary resuscitation (CPR) for children and adults, based on Australian Resuscitation Council Guidelines. 87 (81%) of 107 questionnaires were returned from 15 consultants (17% of respondents), 51 registrars (59%)--of whom 39 (45%) were in training--and 21 resident medical officers (24%). The respondents were based in internal medicine, surgery, emergency medicine, anaesthetics, obstetrics and gynaecology, paediatrics and smaller disciplines (ear, nose and throat, ophthalmology, intensive care, radiology, psychiatry and pathology). Knowledge of CPR in this study population was uneven and overall inadequate. ⋯ Medical officers in training appeared to have better knowledge than their colleagues in postgraduate training programs. As a group, doctors working in emergency medicine, anaesthetics and intensive care had better knowledge of adult resuscitation than their counterparts in the other adult disciplines and had similar knowledge of paediatric resuscitation to that of their paediatric counterparts, although overall knowledge was incomplete in all groups. Basic life support (BLS) and advanced life support (ALS) flow charts for both children and adults should be highly visible throughout the hospital and there is a need for regular training in CPR.